MEDICARE: ALAN P BERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	MD026404E	PA

General Provider Information

NPI Number	:	1548338874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN P BERG MD

Provider Business Mailing Address
First Line	:	1940 W ALLEGHENY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19132-1614
Country	:	US
Telephone Number	:	215-264-1801
Fax Number	:	267-286-8250

Provider Business Practice Location Address
First Line	:	1940 W ALLEGHENY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19132-1614
Country	:	US
Telephone Number	:	215-264-1801
Fax Number	:	267-286-8250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	04/25/2016

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